Basic Information
| Provider Information | |||||||||
| NPI: | 1821157173 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEGNER | ||||||||
| FirstName: | SHARRON | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E LIBERTY ST | ||||||||
| Address2: | SUITE 800 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402021434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2704225000 | ||||||||
| FaxNumber: | 2704225052 | ||||||||
| Practice Location | |||||||||
| Address1: | 534 HILLCREST DR | ||||||||
| Address2: | |||||||||
| City: | BRANDENBURG | ||||||||
| State: | KY | ||||||||
| PostalCode: | 401081222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2704225000 | ||||||||
| FaxNumber: | 2704225052 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2006 | ||||||||
| LastUpdateDate: | 06/04/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 1074710 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 3002274 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 78022746 | 05 | KY | MEDICAID |